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Signature of No. 1 Driver. Date. /. /. Signature of Entrant. For entry to be valid please ensure that all signatures are completed prior to posting POST THIS ENTRY TO Rally Secretary Roger Laird 51a Coutts Road Gore 9710 Please make cheques payable to Eastern Southland Car Club Inc or Deposit into ESCC account using number one Driver as a reference please 020922 0213125 00. I also authorise the medical providers of the event to disclose medical information relevant to injury or illness...
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